Insulin Therapy (for both type 1 DM and advanced type 2 DM):

Rapid-or short-acting insulins are administered to

mimic the prandial(mealtime) release of insulin
and to control postprandial glucose.
Regular insulin should be administered 30 mins before a
meal while rapid acting 15 mins before a meal or 20-
30mins after a meal.

Intermediate acting insulin: NPH (Neutral

Protamine Hagedorn) insulin is used
subcutaneously for basal (fasting) control in type 1
or 2 diabetes and is usually given along with rapid-
or short-acting insulin for mealtime control.

Long acting insulin: Insulin glargine and insulin detemir.

As with NPH insulin, insulin glargine and insulin
detemir are used for basal control and should only
be administered subcutaneously.

Administration: Insulin can't be taken orally to lower blood

sugar because stomach enzymes will break down the insulin,
preventing its action. You'll need to receive it either through
injections or an insulin pump.

Injection: Multiple daily injections that include a combination of a long-

acting insulin combined with a rapid-acting insulin more closely mimic the
body's normal use of insulin

Pump: Pumps are programmed to dispense specific amounts of rapid-

acting insulin automatically. This steady dose of insulin is known as your
basal rate, and it replaces whatever long-acting insulin you were using.

Glucose monitoring: American Diabetes Association

recommends testing blood sugar levels before meals and snacks, before
bed, before exercising or driving, and if you suspect you have low blood
sugar. Careful monitoring is the only way to make sure that your blood
sugar level remains within your target range — and more frequent
monitoring can lower A1C levels.
Healthy eating and monitoring carbohydrates
There's no such thing as a diabetes diet. However, it's important to center your diet on
nutritious, low-fat, high-fiber foods such as:

 Fruits

 Vegetables

 Whole grains

 Eating a healthy diet that

spreads carbohydrate throughout the day.
Physical activity

Everyone needs regular aerobic exercise, and people who have type 1 diabetes are no
exception. First, get your doctor's OK to exercise. Then choose activities you enjoy,
such as walking or swimming, and make them part of your daily routine. Aim for at least
150 minutes of aerobic exercise a week, with no more than two days without any
exercise. The goal for children is at least an hour of activity a day.

Stop smoking and alcohol

Consult doctor routinely to prevent long
term complications of diabetes (eye,
kidney, CVS, CNS)
Treatment for diabetic ketoacidosis includes fluids given
through a vein (intravenous, or IV) to
treat dehydration and to balance electrolytes,
and insulin to lower the blood sugar level and stop the
body from producing ketones.
Glucose (15–20 g) is the preferred treatment for the conscious individual with hypoglycemia, although
any form of carbohydrate that contains glucose may be used. Fifteen minutes after treatment, if SMBG
shows continued hypoglycemia, the treatment should be repeated. Once SMBG returns to normal, the
individual should consume a meal or snack to prevent recurrence of hypoglycemia.